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BioMed Research International
Volume 2016 (2016), Article ID 1295329, 11 pages
http://dx.doi.org/10.1155/2016/1295329
Review Article

Therapeutic Strategies in HCC: Radiation Modalities

1Nuclear Medicine Department, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Centro di Riferimento Oncologico di Basilicata (CROB), Via P. Pio 1, 85028 Rionero in Vulture, Italy
2Istituto di Biostrutture e Bioimmagini, Consiglio Nazionale delle Ricerche, 80145 Napoli, Italy
3Oncology Unit, IRCCS Giovanni Paolo II, 70124 Bari, Italy
4CMO Oplonti Medical Centre, 80058 Torre Annunziata, Italy
5Oncology Unit, Università degli Studi di Foggia, 71122 Foggia, Italy

Received 28 February 2016; Revised 24 May 2016; Accepted 5 June 2016

Academic Editor: Tapas Das

Copyright © 2016 R. Gallicchio et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Patients with hepatocellular carcinoma (HCC) comply with an advanced disease and are not eligible for radical therapy. In this distressed scenario new treatment options hold great promise; among them transarterial chemoembolization (TACE) and transarterial metabolic radiotherapy (TAMR) have shown efficacy in terms of both tumor shrinking and survival. External radiation therapy (RTx) by using novel three-dimensional conformal radiotherapy has also been used for HCC patients with encouraging results while its role had been limited in the past for the low tolerance of surrounding healthy liver. The rationale of TAMR derives from the idea of delivering exceptional radiation dose locally to the tumor, with cell killing intent, while preserving normal liver from undue exposition and minimizing systemic irradiation. Since the therapeutic efficacy of TACE is being continuously disputed, the TAMR with 131I Lipiodol or 90Y microspheres has gained consideration providing adequate therapeutic responses regardless of few toxicities. The implementation of novel radioisotopes and technological innovations in the field of RTx constitutes an intriguing field of research with important translational aspects. Moreover, the combination of different therapeutic approaches including chemotherapy offers captivating perspectives. We present the role of the radiation-based therapies in hepatocellular carcinoma patients who are not entitled for radical treatment.